World's first digital clinic launched to tackle NHS surgery backlogs in London

An East London NHS Trust has announced the launch of the world’s first digital surgery clinic, as part of a pioneering project to radically improve patient outcomes and prevent operation cancellations. 

Barking, Havering and Redbridge University Hospitals NHS Trust has partnered with Sapien Health to give 700 surgery patients access to a bespoke digital platform. This doctor-designed technology facilitates evidence-based, personalised education programmes coupled with 1:1 remote health coaching. 

The structured support, which can be accessed from the patient’s own home, supports them to take ownership of their preparation for surgery and to speed up their recovery. 

This roll-out comes at a critical moment for the NHS, with the backlog for hospital treatment fast approaching a record 7 million people. With the onset of winter set to intensify pressures facing the service, there’s an urgent need for solutions that shorten inpatient stays, release clinical capacity,  prevent surgery cancellations and tackle wait times. 

How the clinic supports patients:

‍Just like running a marathon - surgery requires physical and mental training in the lead up to the surgery itself. Inadequate preparation has serious negative consequences for patients. Currently, 30% of people will experience some form of avoidable complication after surgery, half of which are avoidable with better preparation, and 50% will suffer anxiety, depression and other mental health issues due to their surgery. The team behind the Sapien Health digital clinic designed their technology to solve this serious and expensive problem. 

• Patients are given access to the digital clinic - through an app interface - from several months prior to their scheduled operation date. 
• With a 1:1 coach, a personalised wellness program, and peer support groups users are guided through the preparations necessary to improve the outcomes of their procedure: whether that be weight loss, stopping smoking, improving fitness or mental wellbeing 
• They are given access to insightful health metrics (including sleep tracking and physical activity) and actionable insights 
• Patient who use the digital clinic are much more likely to arrive for their operations in a fit-for-surgery condition
• This reduces the risk of complications and accelerates post-operative recovery 
• All users are empowered and informed on how to make sustainable lifestyle changes that will improve their health on a long-term basis 

How the clinic benefits the NHS: 

• A third of on-the-day cancellations are due to patients not being clinically ready for treatment
• Poor surgical outcome, long recovery times and extended inpatient stays also drain hospital resources 
• The Sapien Health platform has been designed to turn a surgery waiting list into a ‘preparation list’, driving wide-ranging improvements in patient health rather than leaving them in waiting-list limbo 
• The resulting freed-up clinical capacity and resources can then be redirected to deal with service backlogs 

Mr V Shatkar, Consultant Surgeon and General Surgery Specialty Lead at Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT), said: 

“The BHRUT team is excited to be launching our new digital surgery clinic, which will allow us to offer pre-habilitation support to our high-risk elective surgery patients. 

“Research has shown that ‘prehabilitation’ - supporting patients to make sustainable healthy lifestyle changes in the months before their operation - can make a major difference in surgical outcomes. Benefits include early recovery, early return to work and a shorter stay in hospital.

“Going forward, the Sapien platform will empower our patients to take action to reduce the risk of surgical complications. This joined-up approach to prehabilitation will enable us to increase capacity in our hospitals and reduce pressure on our workforce at this important pre-winter time”.

Dr  Robbie Huddleston, CMO and co-founder of Sapien Health said:

“We’re extremely proud to be launching the world’s first digital surgery clinic in partnership with  Barking, Havering and Redbridge University Hospitals NHS Trust.

“The Sapien programme is grounded in established behaviour science principles and is backed by a constant pipeline of research focused on demonstrating clinical effectiveness, economic impact, and patient satisfaction.

“We’re confident that the platform will prove an invaluable resource to patients during the run up to their operation and throughout their recovery period. The team at Sapien will be working closely with the Trust during this partnership period, offering ongoing support as our digital clinic evolves and expands in size.”

Samantha Phillips, a patient from Barking, Havering and Redbridge Hospitals who has taken part in the Sapien Health programme, commented:

“Waiting for planned surgery can be an extremely lonely and worrying period. However, having access to the Sapien Health app allowed me to learn about the actions I could take to prepare myself for my operation as best I could. It was comforting to know that I was setting myself up for a successful procedure, rather than just waiting around for a date.

“The 1:1 coaching from a real person was a fantastic source of comfort and support to me, as it allowed me to have my questions answered so quickly and without having to get in touch with my doctor. The app was very easy to use - I’d definitely like to see this sort of remote support used more widely in the NHS for other procedures and health conditions.”

The platform technology, designed and built by Sapien Health, has been rigorously evaluated and proven through an ongoing cycle of clinical research studies. At South Tees Hospitals NHS Foundation Trust, pre-operative hip and knee replacement participants were given access to the Sapien platform and digital 1:1 coaching. After their 8 week trial:

• Median length of stay in hospital was reduced by 1 day, representing a minimum cost saving of £273 per patient 
• 71% of patients reported improvements in their health self-management ability

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